Prevention

Mandatory vaccinations for both healthcare workers and the public can obtain a rapid improvement in immunization rates, but in the end have high cost, especially in term of litigation. The same results can be achieved putting resources into better organization and communication programs. This is the opinion of Darina O’Flanagan, previous Director of Health Protection Surveillance Centre Ireland and a member of the Advisory Forum of the European Centre for Disease Control since its inception in 2005 up to 2016. She was also one of the founder partners of the European Vaccine Network VENICE and is participating to Pandem project, on behalf of the WHO Regional Office for Europe.

In front of low rates of immunization, many claim for compulsory vaccination, especially as far as healthcare workers are concerned. Their institutional role and ethical purpose is to take care of a subgroup of citizens particularly weak, because of their health conditions. This is always true, but even more when immunocompromised or frail patients, vulnerable to infections, are involved. All healthcare workers have therefore a moral duty not to hurt people they have to take care of, following the ancient principle “Primum non nocere”.

Immunization rates in Italy are decreasing at a worrying trend: international targets for measles eradication and safety thresholds in childhood vaccination are vanishing. Authorities, doctors and families are concerned that a coverage below 86% for MPR (measles, parotitis and rubella) vaccine can impair herd immunity, putting younger babies, immunocompromised people and not-responders at risk.

Since the thalidomide tragedy in the late1950s, there has been a reluctance to include women of childbearing age in clinical trials. However, this fear cannot be used as an excuse to not include females in clinical trials, and, with proper care and regulation, increased female participation has been reached. The United States adopted regulation early on to increase the participation of women, while a new regulation in Europe is going to improve this as well. Here follows an overview of the issue in Canada and in the USA. The third part of this series will deal with new regulation in Europe.

The internet deals a lot with flu, but mostly talks about care and little about prevention. This is the result of a study made by Voices from the Blogs, a spin-off of the University of Milan, on the web-sentiment on influenza and vaccination in Italy.